Adverse obstetric outcomes in early and late adolescent pregnancy

Year 2022, Volume: 39 Issue: 1, 237 - 244, 01.01.2022

Simten Genç , Mehmet Ali Çiftçi , Başak Cıngıllıoğlu , Erhan Aktürk , Orhan Sahın , Sadık Kükrer , Arzu Yurci , Veli Mihmanlı

Abstract

Adolescent pregnant women should be considered as a high risk patient group. The aim of our study is to compare pregnancies in adolescent with adult age group pregnancies and to evaluate maternal and fetal obstetric outcomes. Patients were admitted to Gynecology Department of Okmeydani Training and Research Hospital between January 1, 2015 and December 31, 2019. Pregnant women were divided into 3 groups as Group 1 (aged ≤16 years: n: 280), Group 2 (aged 17-19 years; n: 956) and Group 3 (aged 25-35 years; n: 656). Demographic characteristics of the patients and maternal and obstetric outcomes were recorded.In adolescent age groups,numbers of gravida, parity and abortus, and gestational age, fetal weight, and rates of cesarean delivery were found to be significantly lower relative to age group of 25-35 years Adolescents aged ≤16 years had a significantly lower risk than adults as for preeclampsia (AOR: 9,23 (6,36-11,82) p=0,001),had a significantly higher risk than adults as for low birth weight (AOR: 4,75 (2,26-9,21) p=0,001). and prematurity (AOR: 7,54 (5,12-9,43) p=0,001). Adolescents aged 17-19 years had a significantly higher risk than adults regarding small for gestational age (AOR: 4,48 (1,89-10,67) p=0,001), oligohidramnios (AOR: 2,29 (1,16-4,54) p=0,017), prematurity (AOR: 4,97 (3,1-7,97) p=0,0001) and LBW (AOR: 2,14 (2,71-9,74) p=0,0001).Our study was conducted with a large pregnant group, Since pregnant women in adolescent group are closely associated with preterm birth, delivery of small for gestational age and low birth weight infants, it is important to improve health services to reduce adverse pregnancy outcomes.

Keywords

Adolescent pregnancy, adverse pregnancy outcomes, low birth weight, preterm delivery, teenage pregnancy

References

• 1- Alouini S, Randriambololona D, Randriamboavonjy R. Facteurs de risques de la grossesse, de l'accouchement et du post-partum des adolescentes dans le département du Loiret [Risk factors of teenage pregnancies, deliveries and post-partum in the department of Loiret]. J Gynecol Obstet Biol Reprod (Paris). 2015 May;44(5):443-50.
• 2- Althabe F, Moore JL, Gibbons L, Berrueta M, Goudar SS, Chomba E, Derman RJ, Patel A, Saleem S, Pasha O, Esamai F, Garces A, Liechty EA, Hambidge K, Krebs NF, Hibberd PL, Goldenberg RL, Koso-Thomas M, Carlo WA, Cafferata ML, Buekens P, McClure EM. Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network's Maternal Newborn Health Registry study. Reprod Health. 2015;12 Suppl 2(Suppl 2):S8.
• 3- Briggs MM, Hopman WM, Jamieson MA. Comparing pregnancy in adolescents and adults: obstetric outcomes and prevalence of anemia. J Obstet Gynaecol Can. 2007 Jul;29(7):546-555.
• 4- Brown MA, Lindheimer MD, de Swiet M,etal.The classification and diagnosis of the hypertensive disorders of pregnancy: Statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertens Pregnancy 2001;20:IX-XIV.
• 5- Chandra PC, Schiavello HJ, Ravi B, Weinstein AG, Hook FB. Pregnancy outcomes in urban teenagers. Int J Gynaecol Obstet. 2002 Nov;79(2):117-22.
• 6- Chen XK, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol. 2007 Apr;36(2):368-73.
• 7- Chen XK, Wen SW, Fleming N, Yang Q, Walker MC. Teenage pregnancy and congenital anomalies: which system is vulnerable? Hum Reprod. 2007 Jun;22(6):1730-5.
• 8- Chen CW, Tsai CY, Sung FC, Lee YY, Lu TH, Li CY, Ko MC. Adverse birth outcomes among pregnancies of teen mothers: age-specific analysis of national data in Taiwan. Child Care Health Dev. 2010 Mar;36(2):232-40.
• 9- Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol. 2018;131(2):e49-e64.
• 10- Conde-Agudelo A, Belizán JM, Lammers C. Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study. Am J Obstet Gynecol. 2005 Feb;192(2):342-9.
• 11- Darroch J, Woog V, Bankole A, Ashford LS. Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents. New York: Guttmacher Institute; 2016.
• 12- dos Reis LV, Araujo Júnior E, Guazzelli CA, Cernach MC, Torloni MR, Moron AF. Anomalias Congénitas Identificadas ao Nascimento em Recém-Nascidos de Mulheres Adolescentes [Congenital Anomalies Detected at Birth in Newborns of Adolescent Women]. Acta Med Port. 2015 Nov-Dec;28(6):708-14. Portuguese.
• 13- Fleming N, Ng N, Osborne C, Biederman S, Yasseen AS 3rd, Dy J, Rennicks White R, Walker M. Adolescent pregnancy outcomes in the province of Ontario: a cohort study. J Obstet Gynaecol Can. 2013 Mar;35(3):234-245.
• 14- Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, Yamdamsuren B, Temmerman M, Say L, Tunçalp Ö, Vogel JP, Souza JP, Mori R; WHO Multicountry Survey on Maternal Newborn Health Research Network. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG. 2014 Mar;121 Suppl 1:40-8.
• 15- Ishitsuka K, Yamamoto-Hanada K, Ayabe T, Mezawa H, Konishi M, Saito-Abe M, Ohya Y; Japan Environment and Children's Study Group. Risky Health Behaviors of Teenage Mothers and Infant Outcomes in the Japan Environment and Children's Study: A Nationwide Cohort Study. J Pediatr Adolesc Gynecol. 2019 Apr;32(2):146-152.
• 16- Kawakita T, Wilson K, Grantz KL, Landy HJ, Huang CC, Gomez-Lobo V. Adverse Maternal and Neonatal Outcomes in Adolescent Pregnancy. J Pediatr Adolesc Gynecol. 2016 Apr;29(2):130-6.
• 17- La-Orpipat T, Suwanrath C. Pregnancy outcomes of adolescent primigravida and risk of pregnancy-induced hypertension: a hospital-based study in Southern Thailand. J Obstet Gynaecol. 2019 Oct;39(7):934-940.
• 18- Leppälahti S, Gissler M, Mentula M, Heikinheimo O. Is teenage pregnancy an obstetric risk in a welfare society? A population-based study in Finland, from 2006 to 2011. BMJ Open. 2013 Aug 19;3(8):e003225.
• 19- Mahavarkar SH, Madhu CK, Mule VD. A comparative study of teenage pregnancy. J Obstet Gynaecol. 2008 Aug;28(6):604-7.
• 20- Moran VH. A systematic review of dietary assessments of pregnant adolescents in industrialised countries. Br J Nutr. 2007 Mar;97(3):411-25.
• 21- Naz U. Comparison of obstetric outcome in terms of the risk of low birth weight, preterm delivery, cesarean section rate and anemia in primigravid adolescents and older primigravida. J Coll Physicians Surg Pak. 2014 Feb;24(2):131-4.
• 22- Neal S, Matthews Z, Frost M, Fogstad H, Camacho AV, Laski L. Childbearing in adolescents aged 12-15 years in low resource countries: a neglected issue. New estimates from demographic and household surveys in 42 countries. Acta Obstet Gynecol Scand. 2012 Sep;91(9):1114-8.
• 23- Penfield CA, Lahiff M, Pies C, Caughey AB. Adolescent Pregnancies in the United States: How Obstetric and Sociodemographic Factors Influence Risk of Cesarean Delivery. Am J Perinatol. 2017 Jan;34(2):123-129.
• 24- Robson D, Daniels S, Flatley C, Kumar S. Obstetric and perinatal outcomes for twin pregnancies in adolescent girls. Sci Rep. 2018 Dec 24;8(1):18072.
• 25- Trivedi SS, Pasrija S. Teenage pregnancies and their obstetric outcomes. Trop Doct. 2007 Apr;37(2):85-8.
• 26- Torvie AJ, Callegari LS, Schiff MA, Debiec KE. Labor and delivery outcomes among young adolescents. Am J Obstet Gynecol. 2015 Jul;213(1):95.e1-95.e8.
• 27- Tung I, Beardslee J, Pardini D, Chung T, Keenan K, Hipwell AE. Adolescent childbirth, miscarriage, and abortion: associations with changes in alcohol, marijuana, and cigarette use. J Child Psychol Psychiatry. 2020 Jan;61(1):104-111.
• 28- Turkay Ü, Aydın Ü, Çalışkan E, Salıcı M, Terzi H, Astepe B. Comparison of the pregnancy results between adolescent Syrian refugees and local adolescent Turkish citizens who gave birth in our clinic. J Matern Fetal Neonatal Med. 2020 Apr;33(8):1353-1358.
• 29- Wado YD, Sully EA, Mumah JN. Pregnancy and early motherhood among adolescents in five East African countries: a multi-level analysis of risk and protective factors. BMC Pregnancy Childbirth. 2019 Feb 6;19(1):59.
• 30- WHO Guidelines on Preventing Early Pregnancy and Poor Reproductive Health Outcomes Among Adolescents in Developing Countries. Geneva: World Health Organization; 2011. PMID: 26180870.
• 31- Wilson RE, Alio AP, Kirby RS, Salihu HM. Young maternal age and risk of intrapartum stillbirth. Arch Gynecol Obstet. 2008 Sep;278(3):231-6.
• 32- Wong SPW, Twynstra J, Gilliland JA, Cook JL, Seabrook JA. Risk Factors and Birth Outcomes Associated with Teenage Pregnancy: A Canadian Sample. J Pediatr Adolesc Gynecol. 2020 Apr;33(2):153-159.
• 33- World Health Organization. Iron deficiency anaemia assessment prevention and control: a guide for programme managers. Geneva:World Health Organization;2001;132(WHO/ NHD/01.3)